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术中间歇性充气加压系统联合3M升温仪预防股骨近端抗旋髓内钉手术患者下肢深静脉血栓
Hits: 1805   Download times: 585   Received:December 20, 2020    
作者Author单位UnitE-Mail
王会含 WANG Hui-han 郑州市中心医院高新骨科, 河南 郑州 450000  
王永堂 WANG Yong-tang 郑州市中心医院高新骨科, 河南 郑州 450000  
卢良杰 LU Liang-jie 宁波市李惠利医院骨二科, 浙江 宁波  
田月玲 TIAN Yue-ling 郑州市中心医院高新骨科, 河南 郑州 450000  
苗建华 MIAO Jian-hua 郑州市中心医院高新骨科, 河南 郑州 450000  
王起腾 WANG Qi-teng 郑州市中心医院高新骨科, 河南 郑州 450000  
李凤新 and LI Feng-xin 郑州市中心医院高新骨科, 河南 郑州 450000 362967551@qq.com 
期刊信息:《中国骨伤》2022年35卷,第4期,第349-352页
DOI:10.12200/j.issn.1003-0034.2022.04.010
基金项目:宁波市医学科技计划项目(编号:2019Y04)


目的: 探索股骨转子间骨折患者行新型股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)手术过程中,双下肢间歇性充气加压装置(intermittent pneumatic compression,IPC)联合3M升温仪对预防下肢深静脉血栓形成(deep venous thrombosis,DVT)的效果。

方法: 回顾性分析2016年3月至2019年8月行PFNA手术治疗的127例股骨转子间骨折患者,按术中不同血栓防治方法分为两组,A组63例不使用IPC及3M升温仪;B组64例使用IPC联合3M升温仪。应用彩色多普勒超声动态监测围手术期下肢DVT及变化情况,分别在术毕0、24、72 h以及>72 h(以后每3 d复查1次直至出院)进行下肢静脉血栓形成情况进行监测。

结果: 两组PFNA手术后患者下肢DVT发生情况:B组5例(7.8%),而A组20例(31.7%),两组比较差异有统计学意义(P=0.001);术后0、72 h及>72 h两组下肢DVT比较差异均无统计学意义(P>0.05),但术后24 h时A组DVT形成率明显高于B组(P=0.049);A组患者右下肢及双下肢DVT形成与B组比较差异均无统计学意义(P均>0.05);但A组左下肢DVT形成明显高于B组(P=0.012)。

结论: 术中IPC联合3M升温仪治疗可有效预防行PFNA手术患者下肢DVT形成。
[关键词]:深静脉血栓  股骨骨折  骨折固定术,髓内
 
Intraoperative IPC combined with 3M warming instrument to prevent lower extremity deep venous thrombosis in patients undergoing proximal femoral anti rotation intramedullary nailing
Abstract:

Objective: To explore the effect of intermittent pneumatic compression(IPC) combined with 3M thermometer on the prevention of deep venous thrombosis(DVT) in patients with femoral intertrochanteric fracture.

Methods: From March 2016 to August 2019,127 patients with femoral intertrochanteric fractures who underwent proximal femoral nail antirotation(PFNA) were retrospectively analyzed. They were divided into two groups according to different methods of thrombus prevention and treatment. Among them,63 patients in group A did not use IPC and 3M thermometer;64 cases in group B were treated with IPC combined with 3M thermometer. Color Doppler ultrasound was used to dynamically monitor the DVT and changes of lower limbs during perioperative period. The venous thrombosis of lower limbs was monitored at 0,24,72 h and > 72 h after operation(recheck every 3 days until discharge).

Results: Occurrence of DVT of lower limbs after PFNA operation in two groups:there were 5 cases (7.8%) in group B and 20 cases (31.7%) in group A,there was significant difference between two groups (P=0.001). There was no significant difference in lower limb DVT between two groups at 0,72 and > 72 h after operation(P>0.05),but the formation rate of group A was significantly higher than that of group B at 24 h after operation (P=0.049). There was no significant difference in DVT formation between group A and group B(P>0.05). However,the formation of DVT in group A was significantly higher than that in group B(P=0.012).

Conclusion: Intraoperative IPC combined with 3M thermostat can effectively prevent DVT of lower limbs in patients undergoing PFNA surgery.
KEYWORDS:Deep venous thrombosis  Femoral fractures  Fracture fixation,intramedullary
 
引用本文,请按以下格式著录参考文献:
中文格式:王会含,王永堂,卢良杰,田月玲,苗建华,王起腾,李凤新.术中间歇性充气加压系统联合3M升温仪预防股骨近端抗旋髓内钉手术患者下肢深静脉血栓[J].中国骨伤,2022,35(4):349~352
英文格式:WANG Hui-han,WANG Yong-tang,LU Liang-jie,TIAN Yue-ling,MIAO Jian-hua,WANG Qi-teng,and LI Feng-xin.Intraoperative IPC combined with 3M warming instrument to prevent lower extremity deep venous thrombosis in patients undergoing proximal femoral anti rotation intramedullary nailing[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):349~352
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